Rong-Hsin Yang a , Chien-Hsin Ting b , Yum-Kung Chu b
a Division of Nuclear Medicine, MacKay Memorial Hospital Taitung Branch, No. 1, Lane 303, Changsha Street, Taitung 950, Taiwan
b Department of Nuclear Medicine, Taipei Veterans General Hospital, No. 201, Shipai Road Sec. 2, Beitou District, Taipei 112, Taiwan
Doi: https://doi.org/10.1016/j.jons.2016.07.003 - Article's Language: EN
Cannonball metastases refer to well-defined spherical nodules scattered over both lungs, being a classical presentation of hematogenous tumor spreading. Striking progression of lung metastases without established primary malignancy can raise a diagnostic challenge. We herein report three cases with cannonball metastases at initial presentation. Two patients ended up having a choriocarcinoma but no awareness of the presence of primary tumors, and the third had abrupt lung metastases of endometrial cancer while she was being asymptomatic. Relentless progression was illustrated by clinical and radiographic changes. Ectopic expression of human chorionic gonadotropin (hCG) would seemingly go some way responsible for fulminant cancer spreading associated with poor prognosis in our patients. The goal of this presentation is to raise awareness of ectopic hCG expression in patients presenting with similar astonishing scenarios.
Keywords: Cannonball metastases; Choriocarcinoma; Endometrial cancer; Human chorionic gonadotropin